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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

The influence of body mass index and low-grade systemic inflammation on thyroid hormone abnormalities in patients with type 2 diabetes

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Moura Neto, Arnaldo [1] ; Ribeiro Parisi, Maria Candida [1] ; Tambascia, Marcos Antonio [1] ; Alegre, Sarah Monte [2] ; Pavin, Elizabeth Joao [1] ; Zantut-Wittmann, Denise Engelbrecht [1]
Total Authors: 6
[1] Univ Estadual Campinas, Fac Med Sci, Dept Clin Med, Div Endocrinol, BR-13084971 Campinas, SP - Brazil
[2] Univ Estadual Campinas, Fac Med Sci, Dept Clin Med, Div Internal Med, BR-13084971 Campinas, SP - Brazil
Total Affiliations: 2
Document type: Journal article
Source: ENDOCRINE JOURNAL; v. 60, n. 7, p. 877-884, JUL 2013.
Web of Science Citations: 9

Previous reports highlight the role of systemic inflammation in the genesis of non-thyroidal illness syndrome and type 2 diabetes mellitus (T2DM). Our objective was to assess whether body mass index and the low-grade systemic inflammation would be associated with changes in thyroid hormone metabolism in patients with type 2 diabetes. This was a cross-sectional study of 104 subjects; 52 patients with type 2 diabetes and 52 in a control group, paired by age, gender and body mass index. We measured total (T) and free (F) thyroxine (T4) and triiodothyronine (T3), reverse T3 (rT3), the ratios FT3/rT3, FT3/FT4 and FT4/rT3, clinical parameters (age, gender, diabetes duration and complications, body mass index, waist circumference, hypertension, HbA1c), and high sensitivity C-reactive protein. Patients with DM presented lower levels of TT4 (p=0.006), TT3 (p<0.001) and FT3 (p<0.001) and higher of FT4 (p<0.001), waist circumference (p=0.047) and C-reactive protein (p<0.001). Body mass index was inversely correlated with FT4 (p=0.036) and TT3 (p=0.008). C-reactive protein was positively correlated with rT3 (p=0.001) and inversely with FT4/rT3 (p<0.001) and FT3/rT3 (p=0.014). Body mass index was an independent predictor for FT4 (B=-0.011, p=0.029) and TT3 levels (B=-1.118, p=0.003). Inflammation predicted the FT4/rT3 ratio (B=-0.190, p<0.001). C-reactive protein (B=0.235, p<0.001) and body mass index (B=-0.008, p=0.047) were independent predictors for rT3. In conclusion, type 2 diabetes was associated with a low T3 state. Body mass index and the low-grade systemic inflammation are related to the non-thyroidal illness syndrome in these patients, possibly by altering the activity of peripheral deiodinases. (AU)

FAPESP's process: 10/08854-0 - Non-thyroidal illness syndrome in patients with Diabetes mellitus: laboratory pattern and correlation with glycemic control, complications and inflammatory activity
Grantee:Denise Engelbrecht Zantut Wittmann
Support type: Regular Research Grants